Last Friday night a 47 year old guy came into our ER complaining of radiating chest pain, difficulty breathing and he was also sweating profusely. Got it?
Okay, now a description of our ER suites: There are a total of 18. The first two are combined and this is our “trauma” room. The rest are basically glassed-in cubicles of 8 x 12 feet. The triage nurse puts the guy in cubicle number 6.
Okay. So I get a call to do an EKG (heart tracing) on this guy and the ER doc determines his patient is having an acute MI (heart attack) and starts him on the appropriate drugs . I leave the EKG machine hooked up, so that we can monitor his progress. I do a total of 4 EKG’s on this guy and each one looks worse than the other. He is clearly getting worse and in a world of hurt.
Meantime, I have several other “fires” to put out, and by the time I get back there is less and less room in the cubicle. (Now in addition to the EKG machine, there are 3 IV pumps, 2 nurses, a wife and what’s this coming down the hall? Oh, the crash cart. Sure let’s just jam that damn thing into the room along with everything else!) (It’s aptly named, as it crashes into the pumps, the stretcher, and my machine!)
At this point a little movie begins playing in my head: This guy’s gonna arrest on us, and we’re gonna all be jammed in there like commuters on a subway, and nobody’s gonna be able to stay out of anyone’s way so we can save this guy’s life.
I call one of the nurses over and suggest we move this man to the Trauma room ASAP so we can better work with him if he happens to “crash.”
“Nah. We’re ‘shipping’ him. Ambulance is already enroute. Don’t worry so much, Bill!” Right!
3 minutes later, my little “movie” begins, and the guy totally arrests. In room 6. So what do we do? We unlock the stretcher and go banging out of 6 into Trauma looking like the goddam Keystone Kops! At that point it would have been better to have stayed where we were and done the best we could. All the meds were there, for Chrissakes! Yeah, it would have been difficult, and yeah, the guy should never have been allowed to remain there after not improving, but all that was moot. Precious seconds were lost by moving after he started to code!
Long story short: we got him back, he got stabilized in our ICU and went to one of the larger Atlanta hospitals for further care the next day.
Trauma was unoccupied at the time of the guy’s arrival. It would have been so easy. I should mention that I work in a small hospital as a respiratory therapist and we do have great ER personnel at our hospital. Unfortunately they were all off that night.
Q